The growing youth epidemic of alcohol, tobacco, and vape use: A call for higher health taxes

On March 5, leading doctors and public health advocates gathered at the Philippine Medical Association (PMA) headquarters in Quezon City to sound the alarm on the growing epidemic of alcohol, tobacco, and vape consumption among Filipino youth. With the 2025 elections looming, they issued a challenge to aspiring lawmakers: Will they stand for public health, or will they allow industries that profit from harm and addiction dictate policy?

The evidence presented at the event was nothing short of alarming. According to data from the National Nutrition Survey data, alcohol and tobacco consumption among adolescents aged 10 to 19 doubled between 2021 and 2023. This means hundreds of thousands more Filipino youths are picking up smoking, vaping, and alcohol drinking at an early age. They are falling prey to industries that market these harmful substances.

The human toll of addiction and disease as expressed in the economic cost of alcohol and tobacco consumption is staggering. Action for Economic Reforms’ (AER) research estimates that the total economic burden of these harmful products reaches P1.05 trillion, or 5% of GDP annually. This cost stems from direct healthcare expenditures for treating diseases caused by alcohol and tobacco, the larger impact of lost productivity due to illness and premature death, and the broader social consequences of alcohol, including road crashes, domestic and community violence, and law enforcement costs.

To put this number into perspective, P1.05 trillion is larger than the combined 2025 budgets for the departments of Education and Health. It is a cost borne not just by those who consume alcohol and tobacco, but by every Filipino taxpayer who funds public hospitals, subsidizes healthcare programs, and deals with the economic burden caused by preventable diseases.

Despite this immense financial burden, excise tax collections from alcohol and tobacco in 2021 amounted to only P266.6 billion — barely a quarter of the damage these industries inflict on our economy and society. Companies that manufacture and market alcohol and tobacco products should be held accountable and taxed accordingly. The revenue from these taxes should then be funneled directly into Universal Health Care, as well as treatment and cessation programs to break the cycle of addiction.

Aggressive marketing tactics are a major factor behind the rising prevalence of alcohol and tobacco use among young people. Flavored vape products, cheap alcohol, and celebrity- and influencer-driven promotions are all designed to attract and hook young people. Without stronger regulations and higher excise taxes, the next generation will continue to be the primary target of these industries.

Time and again, the evidence has shown that higher excise taxes on alcohol and tobacco reduce consumption, especially among price-sensitive groups such as young people. Increasing these taxes is a dual-purpose policy: it deters use and generates much-needed revenue for healthcare services.

Yet despite overwhelming evidence supporting higher taxes, current policymakers remain hesitant — largely due to industry pressure.

The recent House Bill 11360 (which has been criticized as the Sin Tax Sabotage Bill), threatens to roll back hard-won gains by making cigarettes more affordable. If passed, the bill could lead to an additional 1.86 million smokers over the next decade while costing the government at least P176.5 billion in lost revenues.

What we need is increasing sin taxes. Tax rates must reflect the true cost from consumption of alcohol, tobacco, and vape products reflect their true cost to society.

With the elections fast approaching, voters must demand accountability from candidates. Where do they stand on Sin Taxes? Will they prioritize the health and well-being of the Filipino people, or will they bow to corporate interests?

This is a public health issue. It is also an issue of governance, integrity, and leadership.

To those running for office in 2025: Stand with the people, not with the industries profiting from harm. Support higher taxes on alcohol, tobacco, and vapes. Protect our youth. Safeguard the future of our nation.

AJ Montesa is a program officer for research and heads the tax policy team of Action for Economic Reforms.